Social media use and health risk behaviours in young people: systematic review and meta-analysis

Computer vision syndrome: a comprehensive literature review

Computer Vision Syndrome is a growing health concern in the digital age, with a reported prevalence of 69.0%. It is caused by screen-related, environmental, ergonomic, and physiological factors, affecting diverse demographics. The COVID-19 pandemic significantly amplified CVS due to increased screen time for remote work, online learning, and social media use, with studies reporting symptoms in up to 74% of individuals. Unique visual challenges from digital screens, including reduced clarity and glare, exacerbate symptoms like dry eyes and discomfort, especially in those with uncorrected vision. Understanding CVS is crucial for mitigating its impact through effective prevention and management strategies. This study explores the causes, diagnosis, management, and prevention strategies of CVS by synthesizing recent findings from optometry, occupational health, digital health, and ergonomics. It also highlights emerging trends such as AI, wearables, and augmented reality while providing practical management strategies. A narrative review of literature from 2014 to 2024 was conducted, focusing on PubMed-indexed, peer-reviewed articles, including meta-analyses and systematic reviews, with priority given to recent, highly cited studies.

Parental Mediation, Digital Media Usage, and Health Literacy: An Exploration Among Chinese Elementary School Students

This study examines the relationship between parental interactions, digital media usage, and health literacy among 19,386 elementary students (ages 6-11) in Guangdong Province, China, using the framework of parental mediation theory. Path analysis revealed that increased digital media usage is associated with decreased health literacy, particularly for short video platforms, which exhibit a significant negative correlation (β = -.335). Parental interaction was found to significantly reduce the use of instant messaging apps (β = -.007) and short video platforms (β = -.008), with the influence being moderated by the student's residence status (boarding or non-boarding). The findings highlight the importance of frequent parental interaction in limiting digital media usage and enhancing health literacy among children. This study suggests that parental mediation theory should pay closer attention to environmental or living status factors, as they can significantly influence its mechanisms of action. Overall, this research contributes to the discourse on digital behavior in childhood and offers evidence-based insights for improving educational and health literacy strategies.

Examining the impact of social media on youth vaping behavior in China: an analysis of the mediating role of perceptions of policy enforcement

Introduction

Research has established that exposure to media and the perceived enforcement of policies can influence outcomes related to (un)healthy behaviors. However, little is known about the underlying processes that may mediate the relationship. The Knowledge-Attitude-Practice (KAP) model serves as an important framework for examining health cognition and behavior change. It asserts that knowledge underpins beliefs, attitudes drive motivation, and practices reflect behaviors. In the realm of e-cigarette cessation, this study investigates the influence of media exposure on perceptions of policy enforcement, which in turn affects risk-benefit evaluations and behavioral outcomes.

Methods

Data for this study were collected in 2024 from an online questionnaire survey (N = 724) conducted in Guangdong China, with participants aged 18 to 30. We primarily employ methods such as mediating effect testing and regression analysis to conduct our data analysis.

Results

The findings suggest that social media exposure, perceived policy enforcement, and perceptions of risks and benefits collectively influence youth vaping behaviors through various mediating pathways. Specifically, the results indicate that exposure to social media has a positive effect on the perceived enforcement of tobacco control policy. This perception, in turn, positively affects both risk and benefit perceptions, thereby either decreasing the likelihood of vaping through heightened perceived risks or increasing it through enhanced perceived benefits.

Discussion

The study highlights the impact of social media content concerning e-cigarettes, noting that both ambiguous advertising and health education materials can enhance the perceived enforcement of tobacco control policy. Furthermore, we investigate the impact of information shared across various social media platforms on vaping behaviors and perceptions of tobacco control policy enforcement. Implications and limitations are discussed.

The Relationship Between Time Spent on Social Media and Adolescent Cigarette, E-cigarette, and Dual Use: A Longitudinal Analysis of the UK Millennium Cohort Study

INTRODUCTION

To estimate the effect of social media use in 14 year olds on risk of and inequalities in cigarette, e-cigarette, and dual use at 17 years, using the UK-representative Millennium Cohort Study (born 2000-2002).

AIMS AND METHODS

The relationship of time spent on social media (using questionnaires [n = 8987] and time-use-diaries [n = 2520]) with cigarette, e-cigarette, and dual use was estimated using adjusted odds ratios (AORs) or relative risk ratios (ARRRs). Effect modification was examined (using parental education as an indicator for socioeconomic circumstances) by comparing adjusted risk differences within low and high-parental education groups. Analyses accounted for prespecified confounders (identified via directed acyclic graphs), baseline outcome measures (to address reverse causality), sample design, attrition, and item-missingness (through multiple imputation).

RESULTS

Time spent on social media was associated with increased risk of cigarette, e-cigarette, and dual use in a dose-response manner. Social media use for ≥2 hours/day (vs. 1-<30 minutes) was associated with increased cigarette (AOR 2.76 [95% confidence interval 2.19 to 3.48]), e-cigarette (3.24 [2.59 to 4.05]), and dual use (ARRR 4.11 [2.77 to 6.08]). The risk of cigarette use among 30 minutes-<1 hour/day users (vs. non-users) were smaller in those with high versus low parental education (ARDs 1.4% vs. 12.4%). Similar findings were observed across the higher time categories. Analyses using time-use-diaries, in complete case samples, and with additional adjustment for baseline outcome measures generally revealed similar findings.

CONCLUSIONS

After accounting for observed confounders and potential reverse causality, findings suggest social media use increases the risk of cigarette, e-cigarette, and dual use in a dose-response manner. Guidance addressing adolescent online safety should be prioritized.

IMPLICATIONS

This study's identification of a dose-response relationship and differential effects across socioeconomic groups, could assist in the development of guidance on time spent on social media. The adverse effects of social media use on adolescent cigarette, e-cigarette, and dual use supports legislation aimed at promoting adolescent online safety. Study findings strengthen calls to prohibit social media marketing of nicotine-related products and importantly highlight the need to increase awareness and understanding of the underlying algorithms which drive adolescent exposure to nicotine-related content on social media to ensure they are functioning in a way that best serves the adolescent population.

Prevalence and associated factors of early sexual initiation among female youth in Tanzania: a nationwide survey

BACKGROUND

Early sexual initiation among female youth in Tanzania presents a significant public health concern, as it is associated with increased risks of unintended pregnancies, sexually transmitted infections and adverse socioeconomic consequences.​ This study aimed to determine the prevalence and associated factors of early sexual initiation among female youth in Tanzania.

METHODS

We used data from the 2022 Tanzania Demographic and Health Survey, conducted between February 24 and July 21, 2022. The sampling frame was stratified by geographic region and urban/rural areas, using a two-stage sampling method that selected primary sampling units based on census enumeration areas, followed by household selection using probability systematic sampling. Data management and analysis were performed using STATA version 18.5, descriptive statistics, and a weighted logistic regression model to determine factors associated with early sexual initiation. Odds ratios (OR) and 95% Confidence intervals (CI) were used to estimate the strength of association.

RESULTS

The overall prevalence of early sexual initiation among female youth in Tanzania was 17.4%. In an adjusted analysis, female youth with no formal education had higher odds of having early sexual initiation (aOR = 3.09, 95%CI: 2.06-4.57) compared to their counterparts who had attained secondary/higher education. Conversely, female youth who were working (aOR = 0.81, 95%CI: 0.62-0.97), having media exposure (aOR = 0.74, 95%CI: 0.58-0.96), and increased in age (aOR = 0.91, 95%CI: 0.87-0.96) were associated with lower odds of having early sexual initiation.

CONCLUSION

This study found a significant proportion of female youths who had early sexual initiation. Lack of education, increase in age, media exposure, and employment were associated with early sexual initiation. There is a great need for a multifaceted approach that includes educational reforms and comprehensive economic strengthening while addressing structural inequalities that increase sexual vulnerability in addressing early sexual debut among female youths.​.

Association of communication methods and frequency with BMI among adolescents during the COVID-19 pandemic: findings from A-CHILD study

Objective

Little is known about the differential impact of communication methods and BMI. Hence, this study aims to examine the association of in-person and online communication with BMI among 13-14-year-old students during the COVID-19 pandemic.

Method

This is a cross-sectional study which used data from the Adachi Child Health Impact of Living Difficulty study among Junior High School students in Adachi City, Tokyo in 2022(N = 3,178). A questionnaire was used to assess communication methods and frequency. BMI was categorized into overweight and obesity (≥ + 1SD), normal weight (-1SD to <+1SD) and underweight (<-1SD) based on WHO standard. Multinomial logistic regression was used to examine the association between communication methods and BMI.

Results

Reduced in-person communication frequency was associated with 94% higher risk of overweight and obese (RRR = 1.94, 95%CI; 1.38, 2.72) while increased online communication frequency was associated with 46% increased risk (RRR = 1.46, 95%CI; 1.10, 1.95). When online and in-person communications were adjusted simultaneously, only reduced in-person communication frequency was associated with a high risk of overweight and obese (RRR = 1.56, 95%CI; 1.09, 2.25). When stratified by gender, a similar trend was observed among females (RRR = 2.12, 95%CI; 1.20, 3.73), but not in males.

Conclusion

Reduced in-person communication frequency was associated with higher risk of overweight and obesity, especially among females, during COVID-19 in Japan.

Problematic media use, mental health literacy, and their interaction in depression among nursing students

BACKGROUND

In the digital age, the relationship between social media use and mental health has gained significant attention. Problematic social media use can negatively affect mental health, while mental health literacy plays a crucial role in mitigating these effects.

OBJECTIVE

This study aimed to explore the relationships between problematic social media use, mental health literacy, and their interaction with depression among nursing students.

METHODS

A convenience sample of 628 nursing students from a university was selected. Participants completed questionnaires assessing social media use, mental health literacy, and depressive symptoms. The tools used included the PHQ-9, the Youth Mental Health Literacy Scale, and the Problematic Use of Mobile Social Media Scale. Multiple logistic regression was performed to examine associations.

RESULTS

The average score for problematic social media use was 56.29 ± 16.22, with 159 students (24.84%) exhibiting problematic behaviors. The average depression score was 5.19 ± 5.32, with 296 students (46.25%) showing depressive symptoms. The average mental health literacy score was 82.46 ± 13.24, with 191 students (29.84%) demonstrating adequate literacy. Logistic regression analysis revealed that both problematic social media use and low mental health literacy were risk factors for depression, with additive and multiplicative interactions. Nursing students with both problematic social media use and low mental health literacy had the highest depression detection rate of 77.2% (88/114), with an odds ratio (OR) of 6.464.

CONCLUSIONS

Depression is prevalent among nursing students. Problematic social media use and low mental health literacy are significant risk factors for depression, and their interaction significantly increases the risk. Reducing problematic social media use and improving mental health literacy can help prevent depression and other negative emotional states among nursing students.

Bibliometrics and altmetrics on halitosis: exploring the top 100 most-cited papers

Halitosis has a multifactorial etiology being of interest by different health areas. The aim of this study was to perform a bibliometric and altmetric analyzes of the top 100 most-cited papers on halitosis to provide a comprehensive view of their scientific and alternative metrics. This would give perspectives on citation dynamics and online attention of the research outputs. A search strategy was designed, tested and applied in the Web of Science database on August 1st, 2023. The 100 most-cited papers were selected by two reviewers. Data on title, year of publication, number of citations, authorship, journal title, study design, halitosis etiology and subject/field of the study or pathogenesis of halitosis were extracted from each paper. Altmetric attention score (AAS) for each paper was registered. Papers were published between 1972 and 2019. Most cited papers were non-systematic reviews (28%). USA was the country with the greatest number of publications (20%). Journals with the greater number of citations were related to dentistry. The altmetric analysis did not show correlation with the citation count but showed a few papers with elevated AAS and a good diffusion in social media. The level of evidence of the study design did not influence the citation number. This can indicate the need for citing studies with more robust designs in order to provide better scientific evidence of citations in epidemiology, etiology, diagnosis and treatment. Databases showed positive correlation among citation counts, but no correlation with the online attention.

Association between sarcopenic obesity and risk of frailty in older adults: a systematic review and meta-analysis

BACKGROUND

Age-related changes in body composition such as muscle loss can lead to sarcopenia, which is closely associated with frailty. However, the effect of body fat accumulation on frailty in old age remains unclear. In particular, the association between the combination of these two conditions, known as sarcopenic obesity, and frailty in older adults is unclear.

OBJECTIVE

To synthesise the association between sarcopenic obesity and the risk of frailty and to investigate the role of obesity in the risk of frailty in old age.

METHODS

Six databases were searched from inception to 29 September 2024. Two reviewers independently extracted the data and assessed the risk of bias for the included observational studies using the adapted Newcastle-Ottawa scale. The control groups consisted of robust, obese and sarcopenic individuals. Meta-analyses were performed to examine the risk of frailty due to sarcopenic obesity and the role of obesity in frailty amongst sarcopenic older adults.

RESULTS

Sixteen eligible studies were included in meta-analyses from 1098 records. Compared to robust individuals, older adults with sarcopenic obesity were more vulnerable to frailty [odds ratio (OR), 3.76; 95% confidence interval (CI), 2.62 to 5.39; I2 = 79.3%; P < .0001]. Obesity was not associated with the risk of frailty (OR, 1.23; 95% CI, 0.99 to 1.53; I2 = 0.0%; P = .501) in sarcopenic older adults.

CONCLUSIONS

Sarcopenic obesity is associated with a high risk of frailty. Sarcopenia and obesity may have synergistic effects on frailty in older adults.

Associations of time spent on different types of digital media with self-rated general and mental health in Swedish adolescents

Although previous studies have suggested an association between digital media use and health, detailed knowledge about how different types of digital media impact adolescent health is limited. This cross-sectional population-based study explored the relationship between time spent on various digital media and adolescents' self-rated general and mental health. The study included 3566 Swedish high school students aged 16-17 years. Associations between time spent on digital media (social media, gaming, watching movies/series/video clips etc. and digital schoolwork) and self-rated health outcomes (general health, self-esteem, symptoms of worry/anxiety and low mood/depression, trust in other people, head/neck/shoulder pain and sleep quality) was assessed. Statistical analyses employed logistic regression models adjusted for covariates (sociodemographic variables and health behaviours). In the adjusted models, spending very high amounts of time (≥ 6 h/day) on any digital media, except schoolwork, was associated with poor self-esteem, symptoms of low mood/depression and poor sleep (ORs 1.35-2.93, p < 0.05). Spending six hours or more on digital media was also associated with worry/anxiety (for social media and gaming), head/neck/shoulder pain (for social media, watching movies/series/video clips and schoolwork), poor general health (for gaming and watching movies/series/video clips) and low trust (for gaming) (ORs 1.39-3.18, p < 0.05). High amounts of time (4-5 h/day) of watching movies/series/video clips was associated with daily symptoms of low mood/depression, neck/shoulder pain, and low trust in other people (ORs 1.46, 1.41, and 1.32, p < 0.05). This study indicates a dose-response relationship between digital media use and adverse health outcomes in adolescents, where adverse associations start to appear after 4-5 h, particularly for watching movies/series/video clips. However, further longitudinal studies, randomized controlled trials and public health interventions focused on healthy and balanced use of digital media are warranted.

Depression, Anxiety, and Stress Symptoms Among Students in Croatia During the COVID-19 Pandemic: A Systematic Review

Background: The COVID-19 pandemic has led to an increased fear of infection, social isolation, financial concerns, and feelings of loneliness and uncertainty. Studies reveal that the pandemic has had a significant negative impact on mental health. This systematic review aimed to investigate the prevalence of depression, anxiety, and stress symptoms among students in Croatia during the COVID-19 pandemic. Methods: A systematic review was conducted following PRISMA guidelines. A literature search was performed on August 5, 2024, using the electronic databases Scopus, PubMed, Web of Science, and PsycINFO. The search utilized the Boolean logical operator expression ('depression' AND 'anxiety' AND 'stress' AND 'COVID-19' AND 'Croatia' AND 'student'). Results: Out of one hundred and fifty-four identified studies, five met the inclusion criteria and were included in the review. The studies used the Generalized Anxiety Disorder 7-item scale (GAD-7), the Patient Health Questionnaire-9 (PHQ-9), and the Depression, Anxiety, and Stress Scale-21 (DASS-21) to assess mental health. The results indicate a high prevalence of symptoms of depression, anxiety, and stress among students in Croatia during the pandemic. Conclusion: A high prevalence of negative affective emotions was observed among students in Croatia during the pandemic. This finding underscores the importance of developing effective strategies for the early identification and management of mental disorders among students, irrespective of the pandemic's conclusion.

Influence of digital health literacy on online health-related behaviors influenced by internet advertising

BACKGROUND

The frequency of health-related information seeking on the internet and social media platforms has increased remarkably. Thus, the ability to understand and select accurate health-related information online, known as EHealth literacy, is crucial for the population. Therefore, this study aimed to evaluate how eHealth literacy influences the critical analysis of oral health-related information obtained from the Internet and its influence on oral health-related behaviors.  METHODS: A cross-sectional online study was conducted with 418 Brazilian adults who responded to the eHEALS questionnaire, with questions regarding the influence of online information on oral health decisions. Socioeconomic and demographic characteristics were also collected.

RESULTS

The mean eHEALS score was 27.85 (± 8.13), with a range spanning from 8 to 40 points. Participants with higher eHEALS scores reported using social media platforms to seek for dentists and to acque information about symptoms, diagnoses, and treatments. Furthermore, this group tended not to disregard professional health recommendations based on Internet information and abstained from utilizing products promoted by digital influencers. In multivariate models, increased eHEALS scores were associated with reduced consumption of products endorsed by digital influencers.

CONCLUSIONS

The findings from this study suggest that individuals with higher scores on the eHealth literacy questionnaire often conduct research on their health status and seek for health care providers on the Internet. Moreover, these individuals were less likely to be influenced by digital influencers.

Social Media Use and Serious Psychological Distress Among Adolescents

Unlabelled

This Research Letter describes the increasing trend of almost-constant social media use among California adolescents and the association with serious psychological distress, focusing on the influence of familial and experiential factors.

The impact of social media interventions on eating behaviours and diet in adolescents and young adults: a mixed methods systematic review protocol

INTRODUCTION

Adolescents and young adults are susceptible population when it comes to healthy eating and dietary behaviours. The increasing use of social media by this age group presents a unique opportunity to promote healthy eating habits. Social media has become a popular platform for promoting health interventions, particularly among young people. However, there is a lack of consensus on the effectiveness of social media interventions in this population. This mixed-method systematic review aims to synthesise the available evidence on the impact of social media interventions on healthy eating behaviours among young people, their qualitative views and user experiences, and the intervention characteristics, behaviour change theories and techniques used to promote healthy eating.

METHODS AND ANALYSIS

We will conduct a comprehensive search of seven electronic databases, including ASSIA, Cochrane Library, Embase, MEDLINE, PsycINFO, Scopus and Web of Science. The search strategy will use a combination of Medical Subject Headings terms and keywords covering three domains: social media, eating behaviours and young people. The search will be limited to peer-reviewed published papers in any language, published from 2000. Three independent reviewers will screen studies based on predetermined eligibility criteria. Data will be extracted and analysed using a convergent segregated mixed-method approach. We will use random-effect meta-analysis or Synthesis Without Meta-analysis for quantitative data and thematic synthesis for qualitative data. Finally, narrative synthesis using concurrent triangulation will be used to bring together the results of the mixed-method data analysis to provide a comprehensive and integrated understanding of the impact and other features of social media interventions. This systematic review will adhere to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses.

ETHICS AND DISSEMINATION

Ethical approval is not required since this systematic review will not collect original data. The outcomes of this review will be shared through peer-reviewed publications and conference presentations and will contribute to the PhD thesis of the primary author.

PROSPERO REGISTRATION NUMBER

CRD42023414476.